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红细胞刚性指数(Ri)的实验及其与经颅多普勒速度(TAMMV)、Gosling 搏动指数 PI、红细胞压积、血红蛋白浓度和红细胞分布宽度(RDW)的相关性。

An experimental erythrocyte rigidity index (Ri) and its correlations with Transcranial Doppler velocities (TAMMV), Gosling Pulsatility Index PI, hematocrit, hemoglobin concentration and red cell distribution width (RDW).

机构信息

Rheology Laboratory, Materials Engineering Post-Graduation Program REDEMAT-UEMG/DESP-ED, State University of Minas Gerais, Belo Horizonte, Minas Gerais, Brasil.

出版信息

PLoS One. 2020 Feb 21;15(2):e0229105. doi: 10.1371/journal.pone.0229105. eCollection 2020.

Abstract

Brain artery velocities (Time-Averaged Maximum Mean Velocity, TAMMV) by Transcranial Doppler (TCD), hematocrit, hemoglobin, Red blood cell (RBC) Distribution Width (RDW) and RBC rigidity index (Ri), when reported together with their correlations, provide a accurate and useful diagnostic picture than blood viscosity measurements alone. Additionally, our study included a sixth parameter provided by TCD, the Gosling Pulsatility Index PI, which is an indicator of CBF (Cerebral Blood Flow) resistance. All these parameters are routine in Hematology except for values of Ri. The rigidity (Ri) of the RBC is the main rheological characteristic of the blood of Sickle Cell Anemia (SCA) patients and several pathologies. However, its quantification depends on many commercial and experimental techniques, none disseminated and predominant around the World. The difference in absorbance values of the blood, during the process of sedimentation in a microwell of a Microplate Reader, is a straightforward way of semi-quantifying the RBC rigidity Ri, since the fraction of irreversibly sickled red blood cells does not form rouleaux. Erythrocyte Rigidity Index (Ri) was calculated using initial absorbance Ainitial (6 s) and final Afinal (540 s), Ri = 1 / (Ai-Af). The Ri of 119 patients (2-17 y / o, M & F) SCA, SCC (Sickle Cell/hemoglobin C), SCD (Sickle Cell/hemoglobin D), Sβ0thal (Sickle Cell/hemoglobin Beta Zero Thalassemia) and 71 blood donors (20-65 y / o, M & F) were measured in our laboratory while the five parameters (TAMMV and PI by TCD, Hct, Hb and RDW) were obtained from medical records. The in vitro addition of hydroxyurea (HU, 50mg /dl, n = 51 patients, and n = 8 healthy donors) in the samples decreased the rouleaux adhesion strength of both donor and patients' blood samples, leading to extraordinarily high Ri values. The correlation between the studied parameters was especially significant for the direct relationships between Ri, TAMMV, and PI.

摘要

经颅多普勒 (TCD) 测量的脑动脉速度(平均时间最大平均速度,TAMMV)、血细胞比容、血红蛋白、红细胞(RBC)分布宽度(RDW)和 RBC 刚性指数(Ri),当与它们的相关性一起报告时,比单独测量血液粘度提供更准确和有用的诊断结果。此外,我们的研究还包括 TCD 提供的第六个参数——Gosling 搏动指数 PI,它是脑血流量 (CBF) 阻力的指标。除了 Ri 值外,所有这些参数在血液学中都是常规的。RBC 的刚性(Ri)是镰状细胞贫血(SCA)患者和几种病理情况下血液的主要流变学特征。然而,其量化取决于许多商业和实验技术,没有一种技术在全球范围内传播和占主导地位。在微量比色皿中沉降过程中血液的吸光度值差异是半定量测定 RBC 刚性 Ri 的一种直接方法,因为不可逆镰状红细胞的部分不会形成缗钱状。使用初始吸光度 Ainitial(6 秒)和最终 Afinal(540 秒)计算红细胞刚性指数 (Ri),Ri=1/(Ai-Af)。我们实验室测量了 119 名患者(2-17 岁,男女)SCA、SCC(镰状细胞/血红蛋白 C)、SCD(镰状细胞/血红蛋白 D)、Sβ0thal(镰状细胞/血红蛋白 Beta Zero 地中海贫血)和 71 名献血者(20-65 岁,男女)的 Ri,而 TCD 的五个参数(TAMMV 和 PI、Hct、Hb 和 RDW)则从病历中获得。在样品中加入羟基脲(HU,50mg/dl,n=51 名患者和 n=8 名健康供体)可降低供体和患者血液样本的缗钱状粘附强度,导致异常高的 Ri 值。研究参数之间的相关性特别显著,因为 Ri、TAMMV 和 PI 之间存在直接关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc81/7034921/bca88ea3ab3a/pone.0229105.g001.jpg

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